Ask Katie K: Tips on terminating clients

Dear ‘Tapering’,

I love your awareness of termination as an important part of the therapeutic process and love even more that you are asking how to use it better, in the service of your clients.

As attachment focused, process-oriented therapists, it’s so important for us to consider the role of attachment experiences in termination, for ourselves and our clients.

Firstly, for yourself, here are a few questions to explore your self-of-the-therapist experience:

• What have been your own experiences of endings and goodbyes?
• How have these shaped your view of self and your expectations of others?
• When you consider raising the topic of termination with a client, what emotions and perceptions come alive for you?
• How might your answers to these questions impact your experience of terminations in therapy? Is there an attachment pattern or tendency that plays out around these for you?

Secondly, for your client:

• What do you know about their experiences of endings and goodbyes?
• How might these have shaped their view of self and their expectations of you and/or the process of termination?
• How do you imagine this client responding when you raise the topic of termination?
• What kind of termination experience would best serve this clients therapeutic process, goals and needs?

With this reflection in mind, can I encourage you to consider TANGOING with your terminations? Inviting your client to make the termination process itself a part of their therapeutic process using the EFT TANGO (the key macro intervention in Emotionally Focused Therapy)?

To consider how we might do this, let’s imagine a case: an individual client has been working with you for a long time and, while they have access to other supports and resources, the therapeutic alliance with you has provided a unique kind of emotional support not readily available in their other relationships. They’ve achieved their goals for therapy and their sense of personal agency is high. You’ve both skirted around the issue of termination several times and today you’ve decided to raise it explicitly. You say: “I wonder if we could talk today about the possibility of you finishing up therapy…” and you watch your client’s face fall.

Let’s TANGO with this:

Move 1: Mirror and Reflect Present Process

Client, I see your face fall – what happens inside for you when I raise the issue of termination?

The client describes their agreement with your assessment of their readiness, as well as the dread and disappointment that comes with the idea of giving up this safe therapeutic space, which they’ve come to treasure so much. You validate and reflect their experience, then transition to…

Move 2: Affect Assembly and Deepening

Let’s look at your experience here more closely, with compassion. When you allow yourself to sit with those feelings of dread and disappointment

–       What happens in your body?

–       What other emotions or sensations come alive?

–       What do you tell yourself (about you, about me, about therapy, about the future)?

–       What do you want to do?

You and the client work together to patiently assemble and organise their experience. They land on a memory of saying goodbye to a much loved family member at 10 years old and feeling abandoned. This person had helped them understand their emotional experience, then they were gone…

Move 3: Choreograph an Engaged Encounter

While that memory is alive for you, can I invite you to be present with your 10 year old self? Can you close your eyes and see that young you, here right now? Can you help me know what you see?

Working collaboratively, you help your client connect with the image and memory of their 10 year old self and enrich this image until it is fully alive. Your client tells you about their young self’s fear and sorrow at abandonment. You validate this and feel it together. You ask the client what that young part needs & support the client to offer this 10 year old part the comfort and reassurance missing at the time of the initial loss. Your client does this…

Move 4: Process the Engaged Encounter

What is it like to offer your young self that comfort? How is it received? Can your young self take it in? What happens then, for each of you? What does this mean for you going forward? How do you feel about the prospect of ending therapy now?

Together, you and your client process the impact of this encounter and its significance to activating event with which our EFT Tango began: you raising the issue of termination. Finally, you transition to…

Move 5: Integrate, Validate, Celebrate!

Client, look what you just did here. Your fears about ending therapy came alive in our session, and instead of avoiding or dismissing these, you turned toward them. You shared them with me and allowed us to explore them together. In doing so, this vulnerable memory of abandonment emerged, giving reason and meaning to your fears about therapy ending.

You were able to be present with that young part of you that experienced that abandonment and offer the comfort and reassurance missing at the time of that initial abandonment. As you did that, your young self received the comfort and you felt stronger and more confident.

While you still have some very valid concerns about ending our therapeutic relationship you’re now able to approach that with more openness and curiosity and better accept your own readiness to end therapy. You tell me the dread and disappointment has greatly diminished. That is just wonderful! Wow! You did this! What a brave and beautiful new move to respond more flexibly and adaptively to your fears.

I hope this very abbreviated (totally fictional) case example offers some idea of the way in which you could Tango with termination and make it a fruitful part of the therapeutic process, Tapering.

I wish you all the best as you seek to turn towards your termination conversations.